Craig Klugman, Ph.D.
If you’re a teen in North Carolina, a new bill before the legislature may make it more difficult for you to get sexually transmitted disease testing and treatment, mental health counseling, pregnancy care or even substance abuse treatment. To receive any of those, a teen would need written, notarized parental consent. A parent could not simply give permission on the phone, via a note, or even by signing a consent form. No, the parent has to use a notary to give permission.
And of course in most states, teens are permitted to receive reproductive health care without parental permission. Supporters of the bill claim that the law is necessary because unfettered access to these health care services is “undermining our families” and puts too much emphasis on individual children. The bill is claimed to be an attempt to give parents more control over their children’s lives and to put a greater emphasis on the family.
Opponents of the bill say that such a law would prevent teens from receiving needed medical and mental health care. Physicians, nurses, even school counselors would be forbidden from talking about these issues or offering counsel to children without that notarized parental document. The result, opponents say, is that teens will wait longer to get help, leading to them being sicker, spreading disease, increasing pregnancy rates, and perhaps even leading to higher suicide rates. Physicians say that this bill is an example of the state inserting itself into the physician-patient relationship.
Perhaps proponents of this law believe in magic—if you never say the words then their teens won’t ask about, learn about, or ever engage in sex or develop mental illness. Interestingly, for the last 40 years North Carolina law has made these services explicitly available to teens. A 2013 report states that North Carolina teen pregnancy rates are at an all-time low while sexual activity has remained the same. Due to the availability of contraception. The state ranks fairly high in terms of sexually transmitted infections in teenagers. But once notarized parental consent is implemented, I have no doubt that these issues will magically disappear.
Laws that legislate morality and that insert a particular moral perspective into the physician-patient relationship rarely have anything to do with improving the health of the population and everything to do with furthering the careers of politicians. In the world of medicine, decisions are supposed to be based on the evidence whether that be experience of many years of practice or increasingly, strong research. Given that these proposed policies will have similar control over life and death that has been the purview of educated physicians, why should a lesser standard of proof be accepted? The answer may be because we have our in a moment of cultural time where belief outweighs reason and fact and North Carolina teens are going to suffer for that.